An Overview of Prospective Drugs for Type 1 and Type 2 Diabetes

Curr Drug Targets. 2020;21(5):445-457. doi: 10.2174/1389450120666191031104653.

Abstract

Aims: The aim of this study is to provide an overview of several emerging anti-diabetic molecules.

Background: Diabetes is a complex metabolic disorder involving the dysregulation of glucose homeostasis at various levels. Insulin, which is produced by β-pancreatic cells, is a chief regulator of glucose metabolism, regulating its consumption within cells, which leads to energy generation or storage as glycogen. Abnormally low insulin secretion from β-cells, insulin insensitivity, and insulin tolerance lead to higher plasma glucose levels, resulting in metabolic complications. The last century has witnessed extraordinary efforts by the scientific community to develop anti-diabetic drugs, and these efforts have resulted in the discovery of exogenous insulin and various classes of oral anti-diabetic drugs.

Objective: Despite these exhaustive anti-diabetic pharmaceutical and therapeutic efforts, long-term glycemic control, hypoglycemic crisis, safety issues, large-scale economic burden and side effects remain the core problems.

Methods: The last decade has witnessed the development of various new classes of anti-diabetic drugs with different pharmacokinetic and pharmacodynamic profiles. Details of their FDA approvals and advantages/disadvantages are summarized in this review.

Results: The salient features of insulin degludec, sodium-glucose co-transporter 2 inhibitors, glucokinase activators, fibroblast growth factor 21 receptor agonists, and GLP-1 agonists are discussed.

Conclusion: In the future, these new anti-diabetic drugs may have broad clinical applicability. Additional multicenter clinical studies on these new drugs should be conducted.

Keywords: FGF21 receptor agonists; GLP agonists; Molecule drugs; SGLT2 inhibitors; diabetes therapeutics; glucokinase activators; insulin degludec..

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Enzyme Activators / pharmacology
  • Glucagon-Like Peptide 1 / analogs & derivatives
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Hypoglycemic Agents / therapeutic use*
  • Insulin, Long-Acting / pharmacology
  • Insulin, Long-Acting / therapeutic use
  • Receptors, Fibroblast Growth Factor / agonists

Substances

  • Enzyme Activators
  • Hypoglycemic Agents
  • Insulin, Long-Acting
  • Receptors, Fibroblast Growth Factor
  • insulin degludec
  • Glucagon-Like Peptide 1